Podcast appearances and mentions of mary mcdermott

On the show this week, we are on location at Township 7 Vineyards & Winery in Langley, celebrating the winery's 25th Anniversary. Our guests include Township 7 General Manager Mike Raffan and Brian Ensor, GM of Chaberton Estate Winery. Mary McDermott, Winemaker, Township 7, talks about several wines from the 7-Stars lineup and the new replacement wines series: Interlude. We also tasted Dry Bacchus with winemaker Gary Zhygailo, which is made from 40-year-old vines growing at the Chaberton Estate Winery. Plus, we'll take some time to speak to Cody Karman, the Township 7 Tasting Room Manager, about serving potato chips and sushi. Finally, we introduce the Fraser Valley Wine Passport program with AJ Cheema, Owner of Otter Trail Winery in Langley, and Jacob Medeiros, Winemaker for Cannon Estate Winery in Mount Lehman, Abbotsford.

The figures provided by Justice Minister Jim O'Callaghan, show reports have dramatically increased in every region across the country. To dicuss this Mary McDermott, chief executive of SAFE Ireland, a domestic and gender-based violence advocacy group.

This week, we focus on a "World of Sparkling wines” for the Holidays, and to begin, we speak with Arianna Carafoli, International Export Director for Bottega, a world leader in prosecco wines. Penticton-based Geoffrey Moss, Master of Wine and Judge at the National Wine Awards of Canada and Anthony recall some of the top medal winners in the Sparkling Wine Category at the 2024 National Wine Awards of Canada. Mary McDermott, Winemaker Township 7 Vineyards & Winery, discusses her sparkling wine program and vineyards in the Fraser Valley and the Okanagan. We are also joined by Benoît Gauthier, Chief Operating Officer & Director of Winemaking and Viticulture at Noble Ridge Vineyard & Winery, to hear about the terroir and sparkling wines of Okanagan Falls.

Mirabella Johnson: Welcome to the Weinberg in the World podcast, where we bring stories of interdisciplinary thinking into today's complex world. My name is Mirabella Johnson, and I am your student host of this special episode of the podcast. I recently graduated from Northwestern's undergraduate Cognitive Science and Global Health Studies programs housed in Weinberg. And I'm currently continuing my education at Northwestern in the Accelerated Public Health Program to obtain a Master of Public Health degree through Feinberg School of Medicine's program in public health. Today, I am very excited to be speaking with Shruti Mehta, who is a Dr. Charles Armstrong Chair in epidemiology, and professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. Thank you so much, Shruti, for taking the time to speak with me today. Shruti Mehta: Thank you so much for having me. I'm really excited to be here. Mirabella Johnson: Likewise. All right. So to start us off today, I'm wondering if you could tell us a bit more about your time at Northwestern as an undergraduate, what you studied, and what were the impactful experiences for you that kind of led you to your current career path? Shruti Mehta: Yeah, so first, I guess I would start by saying that I absolutely loved my time at Northwestern. They were some of the best years of my life, from not just the training that I got, but to the friends that I made, to spending time on that beautiful campus that I still miss. So when I started at Northwestern, I think the only thing that I really knew or I thought was that I was going to go into medicine. So I started with the pre-med curriculum. My father was a physician, and so I had this really strong desire, I think, instilled in me by him to serve. And honestly, other than that, I didn't know very much. I liked biology, I liked math, and so I got kind of started in the pre-med curriculum. I started in chemistry and a really advanced calculus class. And interestingly, my RA my freshman year was also pre-med. But one day I remember going to see her in her room to ask her a question, and she was painting. And she was actually an Art Theory & Practice major. And I had loved art in high school. I was always painting or drawing or creating, but I never thought of it as a major option for me. But it was really meeting her and so many others that were doing really diverse things at the time that I was at Northwestern, that led me to declare Art Theory & Practice as my major in my sophomore year. And I would just say that I'm forever grateful for that. It definitely changed my life. I didn't end up being a physician, and I'm not a practicing artist, but I would say that both of those things play a huge role in how I approach my work. Other things at Northwestern that were impactful. I think one of the great things was just the diversity that I was surrounded by, and it's not just the diversity and who people were or where they came from, but it was what they were doing and what they were interested in. I had friends that were in the engineering school. I spent a lot of time in the Tech building, but I also had my pre-med friends. I had a lot of friends who were artists from my major, and then I had friends in Radio/TV/Film in Communications. And it just exposed me to so many different perspectives, and I think also made me realize that anything was possible. Mirabella Johnson: I love that. Yeah, that is so interesting. I have some similar experiences where there was a time where I really thought I was going to pursue medicine, and then everything gets really stressful at Northwestern as I'm sure you're familiar. Shruti Mehta: Yes, yes. Mirabella Johnson: And there are so many other ways to be involved in the field, and art is something I'm also passionate about. I loved painting, loved drawing, grew up performing. So that's not what I did for my majors, but I stayed involved with it through activities. And Northwestern is just such a great place, in my opinion, for exploring so many different paths. So thank you so much for sharing that. That's awesome. Kind of going off of that, with that all in mind, can you share a bit more on how you ended up landing in public health, and knew eventually that this was the field for you? Shruti Mehta: Yeah, no, and I think you said it well, right? There are so many different ways to be engaged in the field of health and medicine. And I think when I was an undergrad, there wasn't really public health as a major. Well, there certainly wasn't at Northwestern. There wasn't the major that you were, that the minor that you have. And most schools, I think it was probably very rare. I think many people found their way to public health much like I did, going through the medicine route. I don't think I knew what public health was. In undergrad, I don't think I knew what epidemiology was. Like I said, I chose pre-med because that's what I knew, and many people in my generation chose that if you were kind of interested in science and math, and you had that desire, you were medical school bound. So when I graduated, I did apply to medical school. I didn't get into the schools that I wanted to go to, and honestly I wasn't sure because I had this art side. I found myself applying to medical school, but also looking at advertising jobs. And I was a first-generation Indian American, and kids didn't take time off after undergraduate, you went straight into a serious career or you went into a graduate school program, but I really just needed some time. And the way for me to get that time was to find a job and live in Chicago. And so I was pretty scrappy, knocked on doors, the medical school, because I wanted to stay in Chicago. And I thought that the way to do that and the way to kind of figure out if medical school was for me was to do research. And so I didn't find a posted physician, so I literally knocked on doors. I knocked on doors, and I made phone calls because that's what you did at that time. And I met this assistant professor named Mary McDermott, who took a chance on me. She didn't have a job, she didn't really have an opportunity listed, but I think she saw some potential in me, and she hired me to be her research assistant. And I eventually became her research coordinator, I worked for her for two years. I think I started making 850 an hour. And she was doing studies in congestive heart failure and peripheral vascular disease. And I started off just seeing study participants and conducting assessments on them. But I was just hungry to learn and to go beyond just kind of recruiting and seeing participants. So I found myself looking at the data, asking questions. She kind of taught me how to ask those questions, how to answer those questions. I started learning how to do analyses, design research protocols, and then I just wanted to be better at my job. So I asked her about courses, and I found a clinical epidemiology course at the School of Medicine, and I took it. And at the same time as I took that class, another faculty member that I worked for, Joe Feinglass lent me his copy of And the Band Played On. And that is a book that chronicles essentially the early days of the AIDS pandemic, the HIV pandemic. And I'd say it was those two things that kind of together led me to public health and epidemiology. So the clinical EPI course, it just bit. You know when you take a class, and you're just like, "Oh, this makes sense. I get this." It kind of brought together everything that I liked and everything that I was good at, elements of problem-solving, asking questions and answering them. It still had that quantitative side, but in many ways, EPIs, we live in the gray. So it's a little bit of an art as well as a science. And then I was working cardiovascular disease research with Mary, but the And the Band Played On kind of got me interested in HIV. And it was really that it was not just the biology of the virus and all the questions that were unknown at that time, but it was the social issues, the structural issues, and the kind of interplay between those different factors. And so with that, I found myself applying to master's in public health programs, and that's landed where I am today. Mirabella Johnson: That is amazing. And I will say Dr. Feinglass is actually one of my professors. Shruti Mehta: [inaudible 00:07:48] Mirabella Johnson: So him and I are working together on some research potentially for the impact of reforming policing and gun violence prevention, since that's my past. And I also work in behavioral health as a behavioral support specialist. So talking about trauma-informed approaches rather than this tactical approach that really can blow things out of proportion when you're doing mental health and wellness visits. Or even just intervening in a crisis. Shruti Mehta: Absolutely. Mirabella Johnson: Which is awesome. Shruti Mehta: Oh, I love that. Yeah. Mirabella Johnson: Yeah, he's really, he's great. Shruti Mehta: Small world. Mirabella Johnson: Yeah, it is a small world. And I was going to say, I also just worked on a project for one of my classes on congestive heart failure and the low-sodium diet. Because there's surprisingly a small amount of research for how effective the low-sodium diet actually is for congestive heart failure management in terms of symptoms, and morbidity, and mortality. So we were working on that paper literally last quarter. Shruti Mehta: Oh, that's great. Were you collaborating with folks at the School of Medicine as well? Mirabella Johnson: Yeah, yeah. Actually, the majority of my professors in that class were through Feinberg, but then they- Shruti Mehta: Feinberg, okay. Mirabella Johnson: ... in ISGMH, so the Sexual and Gender Minority Institute. Shruti Mehta: Okay, okay. Mirabella Johnson: And they were a wealth of knowledge as well. They were awesome. But I definitely resonate with that, especially as an individual starting out in the field. And I'm sure also it will resonate for so many other students as the interest in Global Health Studies and the related concepts of public health have really, I've seen continue to grow amongst our undergrads, myself included. So with that being said, as someone currently getting an MPH, what encouraged you to then pursue a PhD? Shruti Mehta: Yeah, I think it just wanted more. The expression, sort of, "The more you learn, the more you realize you don't know." I still think I sometimes feel that same way. But I will say, and I say this often that, "When I came to Hopkins, I was going to get my 11-month MPH, and I was headed back to Chicago." I loved Chicago, and that was my plan. But I think that I realized that I wanted to lead work, right? I think there's a lot of things that you could do with an MPH, and you can be a part of incredible work, and people lead programs, but I wanted to lead my own research. I wanted to build my own program, and I wanted to be able to ask my own questions and figure out how to answer them. And I just realized that I had kind of only scratched the surface of what I needed to know to do that with my MPH. And so that was the reason why I stayed to do my PhD. Mirabella Johnson: Yeah, that's awesome. Super helpful. Thank you for going more in-depth about that. So I'm actually from the Chicago and suburbs myself, so I'm kind of in the same boat where I'm very much so on that track, right? Shruti Mehta: Yeah. Mirabella Johnson: I want to stay in the city, and there's so much work to do here. But I also like the idea of potentially doing research. So I'm very grateful to be getting my MPH right now. I knew this is what I want to do, but I've also thought about potentially going for a PhD as well. So that just provides me a lot of food for thought personally. Shruti Mehta: And I think it's great to get that experience in between. I think it can be really just being on the other side now and mentoring PhD students, we see a lot more, and we actually require work experience and see that people who come in with that work experience, that helps to really inform their questions, right? Mirabella Johnson: Yeah. Shruti Mehta: So they come in with a lot of questions, and we help to give them those tools to help to teach them how to answer those questions. Mirabella Johnson: Exactly. Yeah, that's awesome. So tell me a bit more, if you don't mind, about your current projects as well as any future aspirations or goals for your career personally, or for public health as a whole, which is a very- Shruti Mehta: Big question. Mirabella Johnson: ... big question. But I'll let you take it away. Shruti Mehta: So there are a lot of research projects that I'm involved right now. I would say that one of the things when I became chair, so I started as chair in June. And I kept getting asked at that time, and I continually get asked now, "What are you going to give up? What things are you going to stop doing?" But I still find my research really fulfilling and an important part of what I do. And I'd say my whole career, I feel like you answer one question, and then that question leads to the next question. And that's kind of how my career has really developed. I trained as an observational epidemiologist like many do. It was about following people over time, understanding the burden of disease, why some people had morbidity and mortality rates that were higher than others. What were the risk factors for those things? All with an eye of how we intervene, but really the focus was on those observational studies. And my work is always centered in populations that have particular barriers to engaging in services, that we have to prevent and treat predominantly infectious diseases. So a lot of my work is focused on people who inject drugs, men who have sex with men, transgender persons, again, groups that bear a really high burden of infectious diseases, but have these challenges to accessing care. So I spent my early years trying to understand why this is, why were there these barriers to care, what were the challenges people were facing? And then honestly, the past 15 years, we just couldn't observe anymore, we had to actually do something. And so we've learned how to design, implement, evaluate interventions to really support engagement in treatment and prevention services for HIV, for hepatitis C that I also studied. We have incredible tools to prevent and treat infection, but people don't necessarily access them the way that they should because there are challenges with both in their own lives, but also with the systems that deliver them. So I do a lot of work in Baltimore, I also do work in India. And really it's been about exploring different creative interventions to improve engagement. Everything from giving people actually incentives to engage in HIV treatment, right? To say, okay, we know that a person loses daily wages to actually go to the clinic to get treatment in India. So can we actually compensate for that and then improve outcomes? Another project that I'm involved in is actually trying to change the way we deliver services. So in many of the countries where there are large HIV programs, free treatment is delivered through government centers. But they're government centers, so some of the populations that I mentioned don't necessarily feel comfortable going to those government centers. They want to get their care in the community, and they have other needs beyond HIV. So it's about thinking about how do we combine the services that a person needs in a person-centered way, not a disease-centered way, and deliver them from a center that they want to go to and that supports all of their needs? And so we lead a lot of large-scale trials to evaluate how those different types of interventions work in communities. I think you also asked about future aspirations. So for me, it's really about leaving something better than when I came to it. So I'd say that's true for the department that I now lead, as well as the research that I do. I just hope that someday something that I do leads to a big change and impact, and changes people's lives. And so for me, everything that I do, whether it's about the research that I do, or it's, again, my administrative work, it's about people first. That's kind of the place that I want to have impact. And then for public health, that's a bigger question. I think that I look for us to have the courage to ask the big questions, the hard questions, and find the innovative ways that we need to, to answer them. To collaborate across other disciplines and other fields, kind of reach outside our comfort zone, and then hopefully speed up the pace of what we do. I think one of the challenges is the world is moving really quickly, technology is changing, but the pace at which we're able to do things is challenged. So again, just trying to find ways to overcome some of those barriers in our own field, and being able to think big. Mirabella Johnson: That is truly amazing and inspiring. And I think you've already made a huge impact. I am really, really in awe. That's amazing. Yeah. Wow, I'm kind of blown away [inaudible 00:16:06] you. Which I expected, but I just- Shruti Mehta: [inaudible 00:16:09], yeah. Mirabella Johnson: Really happy to hear that. And I also follow a very similar mantra where that's kind of why I decided on public health was, I care about people. I want to make the world or the place that I'm in somehow a little bit better than when I got there. That was how my parents raised me to be as a person. And I think that drew me to public health. And for anyone listening, I just took a course last summer in the public health program at Feinberg for LGBTQ+ Health. And even as an ally and someone very familiar with the intersectional challenges that that community deals with in public health, I really learned so much from that course. And Dr. Lauren Beach, who is truly amazing, they're a wealth of knowledge as well. And a little plug there, but it was such a great course, and you got to work with a community partner. So it really helped solidify what I already knew, which is I love public health. But when you're working with people and like you said, with their challenges, understanding their challenges and meeting them where they're at, to get them to a place that's either better or good for them. A lot of times, that's not happening. So congratulations on all of your accomplishments and contributions to the field really. Going off of that, you had a great transition. So I'd like to ask you to think about everything you know now and what you've done, and kind of bring it back to the undergraduates who may be listening, be thinking about their future directions. So at NU, like we talked about, Global Health Studies offered as an adjunct major or minor in Weinberg now, which is wonderful. We just celebrated, I think 20 years, the program. And that's what drew me to Northwestern. I knew after going to community college to save money during COVID, that I loved Northwestern, I'm from the area, and also I loved public health. I got to take an EPI course at my community college. So thinking about your own work on US public health issues, but also internationally, which is amazing. Do you think Global Health Studies would've been of interest to you in undergrad if it was available? And can you also speak a little bit to the value that you think Global Health broadly has brought into your efforts and your insights as a professional in the field? Shruti Mehta: Yeah, I would say 5000%. If it was offered, it absolutely would've been of interest. And I think it's really special for me that the major's there and that you're going through the MPH program. When I was leaving Northwestern for Hopkins, they were just starting to think about the MPH program. At that point, it was going to be a four-year program, and that was part of the reason I didn't stay because I needed to finish quickly. It was in its early stages. So just the idea that that program is so vibrant, and now there's an undergraduate program is so special to me. So I would've definitely been interested in that. I think it's exactly the kind of thing that I would've been looking for. Again, like I said, it didn't exist when I was there, but I think that we see that so many of the people that come into the field now, people that come into the MPH program or come into the PhD program, are coming from that public health undergraduate background or Global Health Studies major. And I think it's great because they've got this additional preparation for the field that they're eventually going to be in. So I think it's fantastic. In terms of global exposure, I would say that I, even before I started working, it's something that's been a part of my life since I was a child. My parents were immigrants. They lived between two worlds. I was a first-generation kid. We went back to India, their entire family was there. We went back to India every two to three years for my entire childhood. And so for me, that was critical to my upbringing because I was exposed to two cultures my entire life. And it gives you this perspective, not just the challenges of this society that you live in, but the challenges around the world that other people face. And that really shaped me, broadened my worldview. And I think it's important for everyone because we are a global society. I think COVID taught us that, right? We already knew that, but COVID amplified it, we are interconnected. What happens around the world affects us here at home, so we have to care. And I think global problems and challenges are our challenges, right? Obviously that exposure to India as a child has been instrumental even to shaping my career. I chose India to work in very deliberately. But having these experiences working both locally in Baltimore and then globally in India, I've been asking similar questions in different places for many years. And what's kind of fascinating is there's huge differences, obviously between the two setting. But I'm always struck by how many things are similar for the populations that I work with and the questions that I answer, and some of the lessons that can be translated from one setting to another. I think we often say local to global, and try to take lessons from the US and apply them elsewhere. But I'd say it's as much global to local as well, right? So my work in Baltimore informs my work in India, but equally, my work in India informs my work in Baltimore. And so I think just, again, having that broad perspective is critical for all of us. Mirabella Johnson: Yeah, I agree a hundred percent. That is so helpful and insightful. Thank you, Shruti. To quickly close this out today since you have spent so much time with us, and I really appreciate it. I have one more quick question for you. What do you wish you could tell yourself when you were either in my shoes or in a current undergraduate shoes? What do you wish you could tell yourself? Shruti Mehta: Take advantage of opportunities. Be creative. Be curious. Don't worry so much about what the end is going to be, right? Take advantage of the... I think we oftentimes, we get so focused on what am I going to be? And we obviously ask those questions. What do you want to be in five years? What do you want to be in 10 years? But I think sometimes we kind of feel the weight of that, and that may paralyze us a little bit. And so I think thinking about things a little bit more organically, and again, if something comes at you, don't be afraid to take advantage of that opportunity, even if it wasn't a part of your plan, because something amazing could come of that. Mirabella Johnson: Yeah, that's also incredibly helpful to consider. And I would echo that as a recent alumna, and I hope for undergrads, for recent alums and other graduate students too, that they're able to think about that because I really do think that applies to our education, but also to life and what you pursue. So with that being said, thank you so much for this great advice and for taking the time to join us today. Shruti Mehta: Thank you for having me and for sharing your perspective. And I really look forward to also seeing how your career develops. Mirabella Johnson: Thank you. I definitely will be following what you do. What you do is amazing. Thank you everyone for listening to this special episode of the Weinberg in the World podcast. We hope you have a great day. And as always, Go 'Cats. Shruti Mehta: Go 'Cats.  

We're in the Fraser Valley this week at Township 7 Vineyards and Winery. Cody Karman, Township Langley's Tasting Room Manager, fills us in on their hospitality program and some of the fun events they'll be hosting this summer; Mary McDermott, Township's winemaker features their stellar sparkling wines and their wines produced in a unique vineyard in the South Okanagan; Brian Ensor, GM and Gary Zhygailo, the winemaker for Chaberton Estate Winery, join us to talk about their wines, including a rosé, which Anthony raves about; Erinn Kredba, Executive Director for Tourism Langley, announces the opening of a new winery and restaurant, then showcases the amazing breadth of events and attractions in Langley, from learning about history, to sporting events, to farm gates and festivals.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the June 18, 2024, issue.

Join Audible Bleeding team Matthew Chia, Nitin Jethmalani, and Leana Dogbe and editors from the JVS family of publications Thomas Forbes and Gale Tang as we discuss two of the latest highlights in vascular research. First, we welcome Mary McDermott, MD to discuss the discordance between patient-reported outcomes and objective PAD measures in the latest episode of the JVS.  The episode finishes with a stimulating discussion with Alex Chan, PhD to discuss the effect of nicotine on angiogenesis in a murine model of PAD. Articles: Discordance of patient-reported outcome measures with objectively assessed walking decline in peripheral artery disease by McDermott et al. https://doi.org/10.1016/j.jvs.2023.12.027 Chronic nicotine impairs the angiogenic capacity of human induced pluripotent stem cell-derived endothelial cells in a murine model of peripheral arterial disease by Chan et al. https://doi.org/10.1016/j.jvssci.2023.100115 Related Articles: Clinical characteristics and response to supervised exercise therapy of people with lower extremity peripheral artery disease by Patel et al. https://doi.org/10.1016/j.jvs.2020.04.498 Effects of supervised exercise therapy on blood pressure and heart rate during exercise, and associations with improved walking performance in peripheral artery disease: Results of a randomized clinical trial by Slysz et al. https://doi.org/10.1016/j.jvs.2021.05.033  Show Guests: Mary McDermott, MD is the Jeremiah Stamler Professor of Medicine and Preventive Medicine at the Feinberg School of Medicine at Northwestern Medicine.  Among her many accolades and titles, she serves as deputy editor of the Journal of the American Medical Society, and has an extensive career focused on improving our understanding of peripheral arterial disease.   Alex Chan, PhD is a researcher who studied regenerative medicine and cell therapeutics as a postdoctoral fellow in the lab of Dr. Ngan Huang, PhD at the Stanford Cardiovascular Institute.  

Mary McDermott, JAMA Deputy Editor, interviews leading climate scientists and authors Kristie L. Ebi, PhD, MPH, and Jeremy J. Hess, MD, MPH, about effects of climate change on human health and how these effects can be mitigated. Related Content: Introduction to JAMA Climate Change and Health Series

This Week :    THE SHOW   Mary McDermott –  New releases and awards won at Township 7 (Naramata Bench/South Langley) Mary was in London to receive the Best Sparkling Wine in Canada award from the Champagne and Sparkling Wine World Championship! For their Riesling driven  7 Stars Rigel. It was the runner up to...

In this episode Caroline and Nicola chat to Mary McDermott from Safe Ireland about what needs to be done now, in the wake of the conviction of Jozef Puska for Ashling's murder, to enable more women to feel safe - not just walking the streets, but in their homes too. Hosted on Acast. See acast.com/privacy for more information.

In this episode Caroline and Nicola chat to Mary McDermott from Safe Ireland about what needs to be done now, in the wake of the conviction of Jozef Puska for Ashling's murder, to enable more women to feel safe - not just walking the streets, but in their homes too. Hosted on Acast. See acast.com/privacy for more information.

Marion Kelly, CEO, Irish Banking Culture Board, and Mary McDermott, CEO, Safe Ireland

This week Anthony visits Langley, where he speaks with GM's Mike Raffan, Township 7, Norma Walters, Backyard Vineyards and Brian Ensor, Chaberton Estates about the relaunching of the Campbell Valley Wine Route featuring south Langley wineries. We also hear about the wines you can find in the Campbell Valley, from winemakers Township 7's Mary McDermott and Backyard Vineyard's Liam Berti, who highlight their respective sparkling wine programs. Erinn Krebda, Executive Director for Tourism Langley lists the popular festivals, sports events and markets you can enjoy in the region from now through the fall.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the December 13, 2022, issue. Related Content: Audio Highlights

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the August 9, 2022 issue.

Mary McDermott: CEO of Safe Ireland...with TRE's Ger Sweeney

East Clare Life - Mary McDermott - recently retired Post Mistress at Whitegate post office. An event took place recently at the end of May 2022 to mark the occasion where the Whitegate community came out to show their thanks. Hosted by Marie McNamara and dedicated to the late Maura Brogan RIP featured in this programme who passed away suddenly a few days after it was recorded. East Clare Life is Sponsored by James and David Corbett Agricultural Contractors 

Aisling Moloney speaks to Justice Minister Helen McEntee about the Zero Tolerance plan for Domestic, Sexual and Gender Based Violence that is going to Cabinet today and Mary McDermott, CEO of Safe Ireland, gives their reaction to it.

Aisling Moloney speaks to Justice Minister Helen McEntee about the Zero Tolerance plan for Domestic, Sexual and Gender Based Violence that is going to Cabinet today and Mary McDermott, CEO of Safe Ireland, gives their reaction to it.

In the aftermath of the brutal death of Ashling Murphy, how to address violence against women in our society. With Mary Crilly of Sexual Violence Centre Cork, vigil participant Alexandra Ryan and Mary McDermott of Safe Ireland

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the December 14, 2021, issue.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the November 9, 2021 issue.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the October 26, 2021, issue.

Limekiln Lane by Louise Lewis a powerful first-person account of domestic violence in lockdown. This episode of In The Wings, we hear from three professionals who support women experiencing domestic abuse Mary McDermott, CEO of Safe Ireland, Marie Brown, Director of Foyle Women's Aid, and Sarah Benson CEO of Women's Aid

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the September 28, 2021 issue.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the August 3, 2021 issue.

Mary McDermott, CEO of Safe Ireland, on new research revealing the cost of domestic violence to women survivors.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the July 13, 2021 issue.

This episode of How The Yes Was Won is a collection of stories we heard during our interviews that we loved, but just didn't fit in any other episode. We hope you like them as much as we did!Stories are from Mary Ryder, Anne Connolly, Mary Gordon, Mary McDermott, Ursula Barry and Catherine Coffey O'Brien.If you would like to help increase access to abortion in Ireland and elsewhere, please consider donating to the Abortion Support Network.Donate to Abortion Support NetworkWritten and edited by Deirdre Kelly and Aisling Dolan. Narrated by Aisling Dolan. Produced by Deirdre Kelly, Aisling Dolan, Emma Callaghan, Tara Lonij, Davy QuinlivanMusic: A DreamWritten By Jessie Marie Villa, Matthew WigtonPerformed By Jessie Villa Produced ByJessie VillaLicensed via SoundstripeLogo: designed by Fintan Wall,  featuring Maser's Repeal heart   Support the show

In the final episode of How The Yes Was Won, we cover the day of the referendum results. We talk about the mixed emotions from everyone on the day, and the infamous "quiet revolution" quote from Leo Varadkar. We also look at the failures of the current legislation, and how we now need to push for more as it comes up for review. We speak about some of the other areas of injustice in Ireland that we now need to focus on, and hope you agree. Links to additional resources are below.We spoke with Anne Connolly, Alison Spillane, Anita Byrne, Cathie Shiels, Eddie Conlon, Emily Waszak, Ivana Bacik, Linda Kavanagh, Mary Gordon, Mary McAuliffe, Mary McDermott, Mary Ryder, Maeve Taylor, Niall Behan, Sam Blanckensee, Sarah Monaghan, Sean O'Brien, and Ursula Barry for this series.If you would like to help increase access to abortion in Ireland and elsewhere, please consider donating to the Abortion Support Network.Donate to Abortion Support NetworkHealth (Regulation of Termination of Pregnancy) Act 2018ARC Submission on Abortion LegislationIn Our Shoes - Covid PregnancyTogether For SafetyAlliance for ChoiceWritten and edited by Deirdre Kelly and Aisling Dolan. Narrated by Aisling Dolan. Produced by Deirdre Kelly, Aisling Dolan, Emma Callaghan, Tara Lonij, Davy QuinlivanMusic: A DreamWritten By Jessie Marie Villa, Matthew WigtonPerformed By Jessie Villa Produced ByJessie VillaLicensed via SoundstripeLogo: designed by Fintan Wall,  featuring Maser's Repeal heart Support the show

Days of rioting in Northern Ireland last month were blamed on anger over Brexit, but upon closer inspection, the issues run much deeper. A century ago, Ireland was split into an independent, Catholic-majority republic in the south, and a predominantly Protestant north, which stayed in the United Kingdom. A hard-won peace in 1998 stopped decades of conflict. But, Brexit has fueled debate over its future, after the UK left the European Union, and Ireland stayed. Of all the complexities involved in Brexit, Robin Mercer never thought it would stop him from importing flowers. “The same roses we brought in from England, we’ve now had to bring in from Ireland to top them up and they’re 20% dearer. ... Prices are going up.”Robin Mercer, Hillmount Garden Center, Belfast, Northern Ireland Alan and Robin Mercer run the Hillmount Garden Center in Northern Ireland.  Credit: Andrew Connelly/The World  Related: Concerns about an English border loom over Scottish elections“The same roses we brought in from England, we’ve now had to bring in from Ireland to top them up and they’re 20% dearer,” Mercer said.  “Prices are going up.”In the 80 years since Mercer’s grandfather founded the Hillmount Garden Center on the outskirts of Belfast, on Northern Ireland’s east coast, the business has never faced as many obstacles as it does now. The past year of lockdowns has seen a demand for plants and garden furniture outstrip supply, while staff have been furloughed. Now, complicated post-Brexit trading arrangements are acutely hitting the horticultural sector.Doing customs checks on Northern Ireland’s land border with EU-member Ireland was deemed politically sensitive and logistically challenging. The compromise, known as the Northern Ireland Protocol, keeps the North under EU trading regulations. Now, goods such as seeds and plants coming from mainland Britain are checked at Northern Irish ports, instead. The process adds layers of costly administrative burdens for small businesses like Hillmount.“All these garden centers, we’re all family businesses, we’re all working hard. We can’t afford to have staff just sitting in an office. It’s a ridiculous amount of paperwork.”As if that wasn’t enough, earlier this year, Mercer was told that some of his stock was on the Ever Given container ship that blocked the Suez Canal for six days in March. “It’s still stuck there. You couldn’t make it up! It’s been a nightmare year.”Related: Brexit undercuts Northern Ireland's peace pact Politics and ports  The port of Larne, where goods from mainland Britain are checked, has become a key flashpoint for protests.  Credit: Andrew Connelly/The World  The plight of Northern Irish garden centers may seem a trivial price to pay for delivering Brexit, but the protocol appears to be aggravating the region’s fragile political and constitutional order. It’s also causing disruptions at the port of Larne, north of Belfast, where goods from mainland Britain are now checked. Councilor Paul Reid, from the Democratic Unionist Party (DUP), stands under a sign reading “No Irish Sea Border” as a large ferry looms into port. “I asked for a book to come through Amazon, from another part of the UK, and it had to go through customs. This is ridiculous, we are still part of the UK.”Paul Reid, Democratic Unionist Party The port of Larne, where goods from mainland Britain are checked, has become a key flashpoint for protests.  Credit: Andrew Connelly/The World  “I asked for a book to come through Amazon, from another part of the UK, and it had to go through customs. This is ridiculous, we are still part of the UK.”The DUP are staunch advocates of keeping Northern Ireland in the UK. They share power with Sinn Fein, who campaign for a united Ireland. For Reid, any kind of border between the United Kingdom threatens Northern Ireland’s identity.“We are now between a rock and a hard place," said Reid. “Our prime minister did not honor the promise that we are as much British as any other part of the country.”The DUP were enthusiastically pro-Brexit, even though 55% of Northern Irish voters wanted to remain in Europe. They now feel betrayed by Boris Johnson, who in 2019 told an audience in Northern Ireland: “I want to make it absolutely clear that under no circumstances, under no circumstances whatever happens, will I allow the EU or anyone else to create any kind of division down the Irish Sea, or to attenuate our union.”Since customs checks began this year, the harbor has become a focal point for a series of provocations by people who see the protocol as a betrayal. One port worker was allegedly relocated after receiving threats. Protesters threw rocks at police. Graffiti appeared reading: “All port staff are targets.”Local councilor Danny Donnelly, from the opposition Alliance Party, helped to get it removed. “I think some people feel very strongly about the Northern Ireland Protocol. They feel it infringes on their identity, but Brexit has harmed the strength of the union, and the protocol is the result of Brexit. It is the reality of Brexit in Northern Ireland.”Councilor Danny Donnelly, Alliance Party“It’s disgusting that any workers are targeted, everybody should be safe going to work,” said Donnelly. “I think some people feel very strongly about the Northern Ireland Protocol, They feel it infringes on their identity, but Brexit has harmed the strength of the union, and the protocol is the result of Brexit. It is the reality of Brexit in Northern Ireland.”Renewed violenceIn late March, the worst street violence in several years saw 12 days of rioting spread across several towns and cities in Northern Ireland. About 90 police officers were injured and nearly 20 people were arrested after youth, as young as 13, set cars alight and threw petrol bombs and stones at police. Some commentators blamed the protocol. But were young people really motivated by a complex, international trade agreement? In Belfast, the unrest occurred largely in working-class Protestant areas loyal to the United Kingdom. In areas like Shankill Road, where Mary McDermott works as senior psychotherapist at Compass Counseling, communities are effectively segregated and dare not stray into each other’s patch.“From a very young age, you have to be careful because your name or what football shirt you’re wearing can signal whether you’re a Catholic or a Protestant."Mary McDermott, senior psychotherapist, Compass Counseling“From a very young age, you have to be careful because your name or what football shirt you’re wearing can signal whether you’re a Catholic or a Protestant,” said McDermott. One of the so-called "peace walls" that divide Protestant and Catholic areas of west Belfast.  Credit: Andrew Connelly/The World  Mandy McDermott is senior psychotherapist at Compass Counseling, on the predominantly Protestant Shankill Road area of west Belfast.   Credit: Andrew Connelly/The World  Northern Ireland is technically a post-conflict society. McDermott said that sectarianism, combined with intergenerational trauma, poverty and drug and alcohol abuse, creates fertile grounds for clashes. She also hinted at shadowy forces provoking youth to riot.“The lockdowns and restrictions of last year have created a lot of frustration among young males with pent-up energy. But certain elements within certain communities were aware that something was about to happen.”Miles of walls and fences still separate Catholic and Protestant communities, some up to 43-feet-high and linked by gates, which are locked at night. Related: Northern Ireland still divided by peace walls 20 years after conflict Just a few hundred yards from Shankill Road, the Union Jack flags suddenly become Irish tricolors. The vivid murals of balaclava-clad, gun-toting paramilitaries switch from Loyalist to Republican. In this stark atmosphere, criminal gangs with political connections can stir up tension at a moment’s notice, said Stephen Hughes, senior youth worker at St. Peter's Immaculata Youth Center. “Those kids were bullied, threatened and bribed. We have stories of kids getting bags of drugs if they threw petrol bombs. These gangs are wolves in sheep’s clothing. They are organizations who dress themselves up as political warriors or paramilitaries but they are involved in extortion, drugs, counterfeiting and it’s all ego, money, power and control.”Hughes’ staff were on the frontline when the riots erupted, trying to stop young people from getting sucked into the violence and help them find common ground. Related: Northern Ireland's police reform efforts hold lessons for the US“They realize that the other kid on the other side of that wall is so alike to them, it’s unbelievable. Yes, they may have a constitutional difference and a faith difference, but it’s not enough to keep them divided.”Stephen Hughes, senior youth worker, St. Peter's Immaculata Youth Center “They realize that the other kid on the other side of that wall is so alike to them, it’s unbelievable. Yes, they may have a constitutional difference and a faith difference, but it’s not enough to keep them divided.”Hughes thinks that Brexit is not the cause of the unrest, but it heightens preexisting tensions. Recent polling and demographic shifts suggest that a referendum on Irish reunification could well be likely in a decade or two.“If you speak to our kids, they will tell you: ‘We want something different. We don’t want your walls. We don’t want your hate.’ But what we’re seeing now with this Brexit debacle is that it’s being weaponized and used to divide our community. And trust me, there’s no benefit in dividing us.The consequences can be quite scary actually.”

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the May 4, 2021 issue.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the March 2, 2021 issue

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the January 12, 2021 issue

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the December 1, 2020 issue

Mary McDermott, Safe Ireland CEO, says nearly 3,500 women contacted a domestic violence service for the first time during the first national lockdown earlier this year

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the November 3, 2020 issue

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the October 13, 2020 issue

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the August 11, 2020 issue

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the July 28, 2020 issue

News and events from around East Clare for the weekend of the 21st-22nd March 2020. Compiled and read by Ursula Hogan. Interview highlights Businesses are still open in East Clare and Ursula went to Whitegate earlier in the week and spoke to Mary McDermott and Mike Treacy 10.40 Mary McDermott of Whitegate post office and Express shop 15.03 Mike Treacy of Treacy’s foodstore.    24.06 College and Secondray school students Amber and Eva Nolan and Fiona Hogan Mountshannon spoke to Ursula about how the shutdown has affected their studies and hopes for the year. 34.40 Weather forecast  sponsored by Paddy Punch engineering Scariff read by Jim Collins   36.28 An Nuacht le Bernadette Murphy    

  This month on Episode 10 of the Discover CircRes podcast, host Cindy St. Hilaire highlights four featured articles from the February 28 and March 13, 2020 issues of Circulation Research and talks with Dr Mary McDermott about her article Cocoa to Improve Walking Performance in Older People With Peripheral Artery Disease: The Cocoa-Pad Pilot Randomized Clinical Trial.   Article highlights:   Rykaczewska, et al. PCSK6 Is a Key Protease in Vascular Injury   Lebek, et al. SDB Induces Arrhythmias via CaMKII and Late Ina   Mueller, et al. Brain Damage With Heart Failure Napierski, et al. Cut and Paste of cMyBP-C Domains In Situ Transcript Cindy St. Hilaire: Hi. Welcome to Discover CircRes, the podcast of the American Heart Association's journal Circulation Research. I'm your host, Dr Cindy St. Hilaire, and I'm from the Vascular Medicine Institute at the University of Pittsburgh. Today I'm going to share with you four articles selected from the February 28th and the March 13th issues of Circulation Research as well as have an in-depth discussion with Dr Mary McDermott, who is the corresponding author of the study COCOA-PAD Pilot Randomized Clinical Trial. So first, the highlights. The first article I'm sharing with you is titled PCSK6 Is a Key Protease in the Control of Smooth Muscle Cell Function in Vascular Remodeling. The first authors are Urszula Rykaczewska, Bianca Suur, Samuel Röhl, and the corresponding author is Ljubica Matic from the Karolinska Institute in Stockholm, Sweden. The family of proprotein convertase subtilisins/kexins, or PCSKs case for short, are a group of proteases whose role in vascular disease was only recently recognized. Humans with gain- and loss-of-function mutations in PCSK9 exhibit very high or very low levels of cholesterol, respectively, and this information was leveraged for the development of novel, albeit extremely expensive, drugs for regulating cholesterol. However, the role of other members of the PCSK family in cardiovascular disease is not known. This group previously found that PCSK6 was one of the most enriched molecules in human carotid artery plaques as compared to normal arteries, while other PCSK family members did not show the same trend. This prompted the group to further explore the role of PCSK6 in vascular disease. They used a very integrative approach drawing from several independent human biobanks for genetic information, conducting in situ functional investigations using human tissue, also conducting in vivo animal models of vascular injury, including using the PCSK6 knockout mice, as well as ex vivo and in vitro mechanistic studies. And they found that PCSK6 was a key modulator of smooth muscle cell function in vascular remodeling and atherosclerosis through a very novel mechanism implicating MMP14 and MMP2 activation upon cytokine stimulation. Future studies will investigate the role of PCSK6 on atherosclerotic plaque remodeling and instability because, as we know, plaque rupture can have devastating consequences. The second article I will highlight is titled Enhanced CaMKII-Dependent Late I Na Induces Atrial Pro-Arrhythmic Activity in Patients with Sleep-Disordered Breathing. The first author is Simon Lebek, and the corresponding author is Stefan Wagner, from the University Hospital Regensburg in Regensburg, Germany. Sleep-disordered breathing is an umbrella term for any chronic condition involving the complete or partial interruption of breathing during sleep, and this is commonly called sleep apnea. Aside from daytime sleepiness, people with sleep-disordered breathing run the risk of developing arrhythmia, such as atrial fibrillation. Arrhythmias are an electrical problem as opposed to a mechanical one. And at the cellular level, arrhythmias are associated with increased activity of the enzyme calcium/calmodulin-dependent protein kinase 2, or CaMKII, and this protein regulates cellular electrophysiology. Despite the role of CaMKII in propagating electrical signals in the heart, its activity has not been investigated in sleep-disordered breathing patients. This group now shows in a study that used 113 patients undergoing heart surgery that those with sleep-disordered breathing have higher CaMKII in biopsied myocardium than those without the condition. Furthermore, this CaMKII increase was associated with other pro-arrhythmic alterations to the tissue, including increased reactive oxygen species production, enhanced phosphorylation of a major sodium channel, and consequent late firing of sodium currents. Importantly, these alterations could be prevented by pharmacological inhibition of CaMKII, suggesting that such an inhibitor could be a novel treatment strategy for patients with sleep-disordered breathing to reduce their arrhythmia risk. The next article I want to share with you is titled Brain Damage with Heart Failure: Cardiac Biomarker Alterations and Gray Matter Decline. The first authors are Karsten Mueller and Friederike Thiel, and the corresponding author is Matthias Schroeter, and the work was completed at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany. Heart failure leads to decreased blood flow due to a reduced pumping efficiency of the heart, and as a consequence, this can cause insufficient oxygen supply to the tissues, including the brain. Cardiovascular insults, including heart failure, increase the risk for the development of neurological diseases later in life, such as vascular dementia and Alzheimer's disease. Patients with heart failure can show neurological symptoms such as fatigue, nausea, and dizziness. However, the long-term consequences of the effects of heart failure on brain integrity are not well understood. However, several studies suggest that structural changes in the gray matter can occur. This study sought to identify correlations between cardiovascular biomarkers and structural gray matter changes in the brain. They found that patients who suffered from heart failure undergo detrimental brain structural changes. Reduced gray matter density in several regions of the brain correlated with decreased ejection fraction at baseline and increased NT-proBNP, which is a heart failure biomarker. While these observations might reflect structural brain damage in areas that are related to cognition, whether these structural changes facilitate the development of cognitive alterations will need to be proven in future longitudinal studies. The last article I want to share with you before we switch to our interview is titled A Novel "Cut And Paste" Method for In Situ Replacement of Cardiac Myosin Binding Protein C Reveals a New Role for This Protein in the Regulation of Contractile Oscillations. The first author is Nathaniel Napierski, and the corresponding author is Samantha Harris, and they're from the University of Arizona. Actin and myosin are the respective thin and thick filament proteins that allow for muscle contraction, including in the cardiomyocytes, the muscle cells of the heart. Cardiac myosin binding protein C is a critical protein that regulates heart contraction, but the mechanisms by which this protein affects actin and myosin are only partially understood. One reason for this is that cardiac myosin binding protein C localization on the thick filaments may be a key component of contraction, but most in vitro studies cannot spatially replicate arrangements of cardiac myosin binding protein C within the sarcomere. To address this technical gap, this group created a novel hybrid genetic/protein engineering approach that allows for rapid manipulation of cardiac myosin binding protein C in sarcomeres of permeabilized myocytes isolated from genetically engineered Spy-C mice in situ. So essentially, they can do some gene editing in tissue in situ. Using this approach, they were able to rapidly remove and replace cardiac myosin binding protein C. Deletion of this protein fully recapitulates effects obtained using traditional knockout and transgenic mouse models of cardiac myosin binding protein C. However, the ability to rapidly remove and replace this protein identified a new regulatory role for cardiac myosin binding protein C where it functions to dampen contractile oscillations. The novel cut and paste approach should be very useful in testing these new hypotheses of the role of cardiac myosin binding protein C function as well as in defining the role of how spontaneous contractile oscillations affect cardiac contractility during both health and disease. Okay. Now we're going to switch over to the interview portion of the podcast. I have with me Dr Mary McDermott from the Departments of Medicine and Preventative Medicine at Northwestern University's Feinberg School of Medicine. And today we're going to be discussing her manuscript titled Cocoa to Prevent Walking Performance in Older People With Peripheral Artery Disease: The COCOA-PAD Pilot Randomized Clinical Trial. Thank you for joining me. Mary McDermott: Oh, it's a pleasure to be here. Cindy St. Hilaire: Before we dig into the details and the nitty-gritty of the study, could you maybe first explain to us what peripheral artery disease is and perhaps maybe why it's so pernicious? Mary McDermott: Sure. So peripheral artery disease is atherosclerosis of the arteries that supply the legs, and it is a problem because it causes great difficulty with walking. People with peripheral artery disease, or PAD, can typically walk only at one or two blocks before they have to stop because of symptoms or weakness or pain or tightness in their lower extremities, in their legs. And it's also difficult to treat because we have very few medical therapies available that are effective. Cindy St. Hilaire: So this is really something that you only know it's there until you're feeling the adverse symptoms. Mary McDermott: That's correct. Cindy St. Hilaire: That sounds very difficult to treat clinically. This study was called the COCOA-PAD study, and it was a double-blind pilot, randomized clinical trial, and it was designed to test the hypothesis that daily cocoa consumption for about six months improves or prevents the decline in something called the six-minute walk distance test. So my first burning question is, is it okay to eat a lot of chocolate every day? And then my second question is, what is the significance of the six-minute walk test? And maybe you could tell us a little bit about this trial's design. Mary McDermott: Sure. Maybe I'll go in reverse order for those questions. Cindy St. Hilaire: Sure. Mary McDermott: So the trial design, it was a randomized clinical trial. 44 participants with peripheral artery disease were randomized to receive either the cocoa beverages, we asked them to take three a day, or a placebo control, which was very much like the intervention except that the placebo did not have cocoa or cocoa flavanols. And participants were followed for six months, and at baseline and six-month follow-up, we measured the six-minute walk test, and we also did muscle biopsy on those who consented to that, and we also measured lower extremity perfusion with MRI. Now, the six-minute walk test is a test that's very well-validated in patients with peripheral artery disease, and it's really a measure of walking endurance. The way you conduct it is you need a hundred-foot hallway. We use standardized instructions. We actually use a script where the research assistant reads the script with the instructions, and the goal of the test is for the participant to walk as many lengths as they can in the six minutes. And often what you see in people with peripheral artery disease is they start out fine, but after maybe a few hundred-foot lengths, they start to slow down or they start to limp, and many of them cannot finish the six-minute walk without having to stop and rest. If they need to stop, then they can start walking again. Cindy St. Hilaire: That's interesting. Is it a fatigue or is it a pain, or what is prompting them to stop? Mary McDermott: It's symptoms in the legs or the hips classically, and it can be either of those symptoms that you mentioned. It may be a fatigue or a weakness. Some people will say, "I don't have pain. My legs just get weak, and I can't keep walking." Others will have pain. Many will have tightness or burning. And it's interesting, some people will get symptoms mainly in their feet or ankles, others will get it classically in the calves, but many will get it in the hips. And the location depends in part on the location of the atherosclerosis and where they're experiencing the ischemia. Cindy St. Hilaire: Interesting. And so ultimately this is due to the atherosclerotic plaque blocking blood flow? Mary McDermott: Exactly. Right. So when they go to walk, their muscles are not getting an adequate oxygen supply, and that causes these symptoms or weakness in the legs. Cindy St. Hilaire: Interesting. What's so special about cocoa, and what are these flavonoids that you mentioned? Mary McDermott: Sure. Cocoa actually comes from the cacao plant, and in that plant there's cocoa, but also something called cocoa flavonoids, and this is a nutritional substance. And there's a variety, but in cocoa, epicatechin is the most prevalent flavonoid. And flavonoids have health benefits that include improving blood flow by causing dilation of vessels, but also, they've been shown to have favorable effects on muscles, skeletal muscle. And so this is particularly potentially helpful in peripheral artery disease because, obviously, patients with PAD have difficulty with blood flow because of those atherosclerotic blockages, but also they've been shown to have skeletal muscle abnormalities, probably because their leg muscles aren't getting enough oxygen. So they develop loss of muscle mass, they develop mitochondrial dysfunction and other abnormalities in their muscle that also make it hard for them to walk. So cocoa and cocoa flavonoids are an attractive therapy in PAD because they both can improve blood flow and improve the health of the skeletal muscle in the legs. Cindy St. Hilaire: Interesting. So it's kind of a two-pronged approach to possibly helping these patients. What was the scientific evidence out there that the flavonoids or maybe even just dark chocolate may be beneficial, and how was your study different from other studies? Mary McDermott: Some of the evidence comes from animal studies where it's clearly been shown to improve skeletal muscle mitochondrial activity and muscle growth and also blood flow. But there were also some preliminary studies in humans, a couple of them really small sample sizes of patients with heart failure, showing improvements in skeletal muscle health. But there was one trial published about five years ago in patients with PAD where the PAD patients were given one dose of dark chocolate or one dose of milk chocolate, and that one dose helped them achieve increased walking distance on a treadmill about two to three hours later. But to our knowledge, no prior studies had tested whether a daily dose of cocoa could improve six-minute walk or improve skeletal muscle or blood flow. Cindy St. Hilaire: So should I eat chocolate every day? Mary McDermott: Well, there's a couple of important things about chocolate. First of all, most of the chocolate that you can buy at the store is not the type we used in our study. Oftentimes chocolate is alkalized, and what that does is it makes it taste better, but it also removes some of those cocoa flavonoids that are thought to be responsible for the health benefits. The cocoa that we studied was rich in the cocoa flavanols. It had not been alkalized, and it was more of the dark chocolate. So if you want to eat it for health benefits, you need to read the label, and it should tell you whether the chocolate has been alkalized. The other thing to take note of is, of course, many forms of chocolate come with a lot of calories or sugars, so that can be problematic if it leads to weight gain. The chocolate that we used in our study and the placebo added about 180 calories per day to the diet, and prior to starting the study we did a little bit of diet counseling with all the participants, and we helped them identify drinks or foods they were eating that maybe could be removed so that they could take the 180 calories without gaining weight. And we did not find weight gain in either group in this study. Cindy St. Hilaire: That's good. That's good. One of your results I found interesting was that it showed that this daily supplementation of cocoa in the diet improved the six-minute walk test at a timeframe that was shortly after the chocolate dosing, but not 24 hours after. Can you maybe talk about that result and what the implications for that mean? Mary McDermott: Sure. Because of that prior trial that I mentioned, which indicated that cocoa had an acute effect, we were interested in separating out the acute and the chronic effects. So we did two six-minute walk tests at six-month follow-up. The first was performed two and a half hours after the final cocoa dose, and the second was performed 24 hours later. And we saw the biggest benefit at the time point that was two and a half hours after the final cocoa dose. The benefit was about 42 meters favoring the cocoa intervention. When participants came back 24 hours later, the difference between the intervention and the placebo was only 18 meters, and that didn't quite achieve statistical significance in our primary analyses. Now, we were a little surprised by the difference in those findings. One possible explanation is that cocoa has both the chronic and acute benefit and that first measurement reflected both the acute and the chronic benefits. So that's one possible explanation. Another is, interestingly, we found that the placebo group had a bit of a learning effect between the two-and-a-half-hour time point and the 24-hour time point, and it's possible that that explained the diminishment in the difference of the 24-hour time point. But we didn't see that learning effect in the cocoa group, so that didn't quite make sense. In my mind, the best explanation is there may be both an acute and a chronic effect, and we saw the benefit of both of those at that first time point. Cindy St. Hilaire: Interesting. And a learning effect, by that you just mean the patients just learned to do the test better? Mary McDermott: Yeah. So they got more comfortable with it between the first and the second measurement, which were just 24 hours apart. Prior study in peripheral artery disease patients has not shown a learning effect. But in the prior study, the six-minute walk tests were performed one or two weeks apart. And to my knowledge, no one's ever tested it just 24 hours apart. Cindy St. Hilaire: Interesting. Very interesting. What was really the most challenging aspect of  this study? Can you talk about some of the limitations also? Mary McDermott: Sure. I'd say the biggest limitation was the sample size. This was a pilot study. It's not a definitive result. There were 44 people, so that is certainly a limitation. And perhaps related to that, we did see some imbalances at baseline between the two groups in terms of BMI and prevalence of African-Americans between the two groups. Our analyses do adjust for those differences to try to overcome that potential difference. With regard to challenges, well, recruiting for studies of peripheral artery disease is always a challenge because the patients are limited in their own mobility, and it can be hard for them to come in for the study visits. A study like this requires multiple visits at baseline and follow-up. Another potential challenge is that the adherence rate was about 64% in the intervention group versus closer to 80% in the placebo group. We don't know- Cindy St. Hilaire: Oh, interesting. What do you think that is? Mary McDermott: We don't know exactly why. It's possible that the cocoa intervention had a different taste and maybe was not as palatable, but since participants only had their own drink, we didn't ask them to compare, and we can't say that for sure. That could've been just due to chance. Cindy St. Hilaire: Sure. Wow. Well, hopefully, a future study can help figure that out. Speaking of that, what would be next really in terms of kind of translating this study into either a bigger study or really translating it to the clinic? What do you see for this moving forward? Mary McDermott: Well, couple things. I think most immediately, because there are so few therapies for peripheral artery disease and because cocoa has essentially no side effects with the caveat being the potential for weight gain, that it would be reasonable to recommend it to patients who are really symptomatic and can't seem to get better with standard options such as exercise or maybe in addition to exercise. But I do think before we can reach a definitive conclusion, a definitive trial is needed. We have applied, we have submitted a grant application to obtain funding to do a larger study, but we'll need to wait and see how that goes. Cindy St. Hilaire: Well, hopefully, that gets funded because I would love any excuse to eat a little more chocolate, even if it's non-alkalized. Well, great. Well, thank you so much for joining me today, Dr McDermott. This is a wonderful study, and I wish you the best of luck on that next funding to do a larger study. Mary McDermott: Well, thank you so much. I really appreciate your interest in this work. Thank you. Cindy St. Hilaire: That's it for highlights from the February 28th and March 13th issues of Circulation Research. Thank you so much for listening. This podcast is produced by Rebecca McTavish, edited by Melissa Stoner, and supported by the editorial team of Circulation Research. Some of the copy text for highlighted articles was provided by Ruth Williams. Thank you to our guest, Dr Mary McDermott. I'm your host, Dr Cindy St Hilaire, and this is Discover CircRes, your source for the most up-to-date and exciting discoveries in basic cardiovascular research.  

Most people with peripheral artery disease, PAD, have great difficulty walking and few treatments to help. Preliminary results of a new Northwestern Medicine study suggest that cocoa may have a therapeutic effect on walking performance in people with PAD. Dr. Mary McDermott led this study and shares the results.

Editor's Summary by Mary McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the November 26, 2019 issue

Editor's Summary by Mary McDermott, MD, Senior Editor in Chief of JAMA, the Journal of the American Medical Association, for the April 02, 2019 issue  

Dr. C. Michael Gibson discusses the trial findings with Dr. Mary McDermott at AHA 2017.

It’s the new – and shortened – edition of the STL United Soccer Saturday Show. Joining Tom and the crew in-studio is Steve Mattingly, who is here to discuss the Mary McDermott Tournament. For more information on Bill McDermott’s “Mary McDermott’s 8th-Annual 3rd-Grade Basketball Tournament” at the Immacolata Parish: http://www.cycstl.net/node/4178 On Facebook: https://www.facebook.com/Mary-McDermott-Basketball-Tournament-407740638065/?fref=tsThe post Dec. 3, 2016 – STL United Soccer Saturday – Segment 1 appeared first on insidestl.com.

It’s the new – and shortened – edition of the STL United Soccer Saturday Show. Joining Tom and the crew in-studio is Steve Mattingly, who is here to discuss the Mary McDermott Tournament. For more information on Bill McDermott’s “Mary McDermott’s 8th-Annual 3rd-Grade Basketball Tournament” at the Immacolata Parish: http://www.cycstl.net/node/4178 On Facebook: https://www.facebook.com/Mary-McDermott-Basketball-Tournament-407740638065/?fref=tsThe post Dec. 3, 2016 – STL United Soccer Saturday – Segment 1 appeared first on insidestl.com.

More with Steve Mattingly and the the Mary McDermott Tournament. For more information on Bill McDermott’s “Mary McDermott’s 8th-Annual 3rd-Grade Basketball Tournament” at the Immacolata Parish: http://www.cycstl.net/node/4178 On Facebook: https://www.facebook.com/Mary-McDermott-Basketball-Tournament-407740638065/?fref=tsThe post Dec. 3, 2016 – STL United Soccer Saturday – Segment 4 appeared first on insidestl.com.

More with Steve Mattingly and the the Mary McDermott Tournament. For more information on Bill McDermott’s “Mary McDermott’s 8th-Annual 3rd-Grade Basketball Tournament” at the Immacolata Parish: http://www.cycstl.net/node/4178 On Facebook: https://www.facebook.com/Mary-McDermott-Basketball-Tournament-407740638065/?fref=tsThe post Dec. 3, 2016 – STL United Soccer Saturday – Segment 4 appeared first on insidestl.com.

“Mr. Soccer,” Bill McDermott, checks-in to discuss the United States’ Men’s National Team deciding to part ways with Head Coach Jurgen Klinsmann and other soccer happenings. For more information on Bill McDermott’s “Mary McDermott’s 8th-Annual 3rd-Grade Basketball Tournament” at the Immacolata Parish: http://www.cycstl.net/node/4178 On Facebook: https://www.facebook.com/Mary-McDermott-Basketball-Tournament-407740638065/?fref=tsThe post Nov. 26, 2016 – STL United Soccer Saturday – Segment 2 appeared first on insidestl.com.

“Mr. Soccer,” Bill McDermott, checks-in to discuss the United States’ Men’s National Team deciding to part ways with Head Coach Jurgen Klinsmann and other soccer happenings. For more information on Bill McDermott’s “Mary McDermott’s 8th-Annual 3rd-Grade Basketball Tournament” at the Immacolata Parish: http://www.cycstl.net/node/4178 On Facebook: https://www.facebook.com/Mary-McDermott-Basketball-Tournament-407740638065/?fref=tsThe post Nov. 26, 2016 – STL United Soccer Saturday – Segment 2 appeared first on insidestl.com.

The American Cancer Society breast cancer screening guidelines have been changed to recommend annual screening for women older than 45 and every other year screening for women older than 55. Older women should only pursue screening if they have a more than 10 year life expectancy. These guidelines were somewhat controversial and were published in the October 15, 2015 issue of JAMA. JAMA Senior editor Mary McDermott interviews Nancy Keating, Evan Myers and Elizabeth Fontham to discuss these guidelines in detail.